{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:09:33Z","timestamp":1790636973259,"version":"4.1.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["AID-OAA-A-14-00060"],"award-info":[{"award-number":["AID-OAA-A-14-00060"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30AI094189"],"award-info":[{"award-number":["P30AI094189"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about youth-led approaches to addressing HIV-related outcomes among adolescents and young adults (AYA) living with HIV. In response, Project YES! hired and trained youth living with HIV as peer mentors (YPMs) in four HIV clinics in Ndola, Zambia to hold meetings with 276 15-24-year-olds living with HIV. Within this randomized controlled trial, a qualitative sub-study was conducted to explore YPMs\u2019 implementing experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In-depth interviews were conducted with the eight YPMs (50% female) ages 21\u201326 years. YPMs were asked about their experiences working with clients, their feedback on program components, and what the experience meant to them personally and professionally. Interviews were audio-recorded, transcribed verbatim, and thematic analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>YPMs connected with AYA clients by discussing shared struggles, modeling positive health behaviors, and establishing judgement-free environments. YPMs experienced powerful personal transformations in HIV-related health behaviors, conceptions of self, and plans for the future. Many expressed now seeing themselves as community leaders\u2013\u201cambassadors\u201d, \u201cgame changers\u201d\u2013and \u201cnot just alone in this world.\u201d They described newfound commitments to reaching personal and professional goals. YPMs were adamant that Project YES! should expand so other HIV-positive AYA might benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Well-trained and compensated YPMs who are integrated into HIV clinics can support AYA in unique and important ways due to their shared experiences. The transformational experience of becoming YPMs empowers youth to see themselves as role models and leaders. Future programs should engage youth living with HIV as partners in efforts to end the HIV epidemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0261948","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T13:50:45Z","timestamp":1643896245000},"page":"e0261948","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["\u201cIt must start with me, so it started with me\u201d: A qualitative study of Project YES! youth peer mentor implementing experiences supporting adolescents and young adults living with HIV in Ndola, Zambia"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3248-9213","authenticated-orcid":true,"given":"Virginia M.","family":"Burke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana","family":"Frimpong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Miti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan K.","family":"Mwansa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Abrams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine G.","family":"Merrill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Denison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"pone.0261948.ref001","author":"UNICEF","year":"2019","journal-title":"Global and regional trends"},{"key":"pone.0261948.ref002","year":"2021","journal-title":"Viral Load (VL): Department of Health and Human Services (HHS) Office of Infectious Diseases and HIV\/AIDS Policy (OIDP)"},{"key":"pone.0261948.ref003","author":"UNAIDS","year":"2018","journal-title":"Undetectable = Untransmittable: Public Health and HIV Viral Load Suppression"},{"issue":"9903","key":"pone.0261948.ref004","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/S0140-6736(13)61998-4","article-title":"Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here?","volume":"382","author":"MS Cohen","year":"2013","journal-title":"The Lancet"},{"key":"pone.0261948.ref005","author":"Zambia Ministry of Health","year":"2017","journal-title":"Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016: First Report: Zambia Ministry of Health"},{"issue":"1","key":"pone.0261948.ref006","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/QAI.0b013e318199072e","article-title":"Antiretroviral therapy adherence, virologic and immunologic outcomes in adolescents compared with adults in southern Africa","volume":"51","author":"JB Nachega","year":"2009","journal-title":"Journal of acquired immune deficiency syndromes (1999)"},{"issue":"12","key":"pone.0261948.ref007","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1001\/archpediatrics.2009.204","article-title":"Predictors of Suboptimal Virologic Response to Highly Active Antiretroviral Therapy Among Human Immunodeficiency Virus\u2013Infected Adolescents: Analyses of the Reaching for Excellence in Adolescent Care and Health (REACH) Project","volume":"163","author":"H Ding","year":"2009","journal-title":"Archives of pediatrics & adolescent medicine"},{"key":"pone.0261948.ref008","article-title":"Viral suppression in adolescents on antiretroviral treatment: review of the literature and critical appraisal of methodological challenges","author":"RA Ferrand","year":"2016","journal-title":"Tropical Medicine & International Health"},{"issue":"2","key":"pone.0261948.ref009","doi-asserted-by":"crossref","first-page":"e0116144","DOI":"10.1371\/journal.pone.0116144","article-title":"Factors associated with virological failure and suppression after enhanced adherence counselling, in children, adolescents and adults on antiretroviral therapy for HIV in Swaziland","volume":"10","author":"K Jobanputra","year":"2015","journal-title":"PLoS One"},{"key":"pone.0261948.ref010","author":"World Health Organization","year":"2013","journal-title":"HIV and adolescents: guidance for HIV testing and counselling and care for adolescents living with HIV"},{"issue":"3","key":"pone.0261948.ref011","doi-asserted-by":"crossref","first-page":"e000004","DOI":"10.1136\/bmjgh-2015-000004","article-title":"Systematic review and meta-analysis of the adolescent HIV continuum of care in South Africa: the Cresting Wave","volume":"1","author":"BC Zanoni","year":"2016","journal-title":"BMJ global health"},{"issue":"3","key":"pone.0261948.ref012","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1007\/s10461-017-1944-x","article-title":"Factors related to incomplete adherence to antiretroviral therapy among adolescents attending three HIV clinics in the copperbelt, Zambia","volume":"22","author":"JA Denison","year":"2018","journal-title":"AIDS and Behavior"},{"issue":"1","key":"pone.0261948.ref013","doi-asserted-by":"crossref","DOI":"10.7448\/IAS.18.1.19358","article-title":"\u2018\u2018The sky is the limit\u201d: adhering to antiretroviral therapy and HIV self-management from the perspectives of adolescents living with HIV and their adult caregivers","volume":"18","author":"JA Denison","year":"2015","journal-title":"Journal of the International AIDS Society"},{"issue":"1","key":"pone.0261948.ref014","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/09540120600652303","article-title":"Stigma and social barriers to medication adherence with urban youth living with HIV","volume":"19","author":"D Rao","year":"2007","journal-title":"AIDS care"},{"issue":"5","key":"pone.0261948.ref015","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1089\/apc.2006.20.359","article-title":"Social stigma concerns and HIV medication adherence.","volume":"20","author":"LS Rintamaki","year":"2006","journal-title":"AIDS Patient Care & STDs"},{"issue":"7","key":"pone.0261948.ref016","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S1473-3099(13)70363-3","article-title":"Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges","volume":"14","author":"ED Lowenthal","year":"2014","journal-title":"The Lancet infectious diseases"},{"key":"pone.0261948.ref017","author":"World Health Organization","year":"2016","journal-title":"What\u2019s new in adolescent treatement and care"},{"key":"pone.0261948.ref018","doi-asserted-by":"crossref","first-page":"20027","DOI":"10.7448\/IAS.18.2.20027","article-title":"Building our youth for the future","volume":"18","author":"LG Bekker","year":"2015","journal-title":"Journal of the International AIDS Society"},{"issue":"Suppl 1","key":"pone.0261948.ref019","first-page":"85","article-title":"Young key populations and HIV: a special emphasis and consideration in the new WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations","volume":"18","author":"R Baggaley","year":"2015","journal-title":"J Int AIDS Soc"},{"key":"pone.0261948.ref020","author":"UNAIDS","year":"2016","journal-title":"Ending the AIDS epidemic for adolescents, with adolescents: A practical guide to meaningfully engage adolescents in the AIDS response"},{"key":"pone.0261948.ref021","doi-asserted-by":"crossref","first-page":"19434","DOI":"10.7448\/IAS.18.2.19434","article-title":"Tailored combination prevention packages and PrEP for young key populations","volume":"18","author":"A Pettifor","year":"2015","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0261948.ref022","doi-asserted-by":"crossref","first-page":"19408","DOI":"10.7448\/IAS.18.2.19408","article-title":"Adolescent girls and young women: key populations for HIV epidemic control","volume":"18","author":"RC Dellar","year":"2015","journal-title":"Journal of the International AIDS Society"},{"issue":"Suppl 3","key":"pone.0261948.ref023","doi-asserted-by":"crossref","first-page":"S195","DOI":"10.1097\/QAD.0000000000001509","article-title":"Youth engagement in developing an implementation science research agenda on adolescent HIV testing and care linkages in sub-Saharan Africa","volume":"31","author":"JA Denison","year":"2017","journal-title":"AIDS (London, England)"},{"issue":"4","key":"pone.0261948.ref024","doi-asserted-by":"crossref","first-page":"e0230703","DOI":"10.1371\/journal.pone.0230703","article-title":"Project YES! Youth Engaging for Success: A randomized controlled trial assessing the impact of a clinic-based peer mentoring program on viral suppression, adherence and internalized stigma among HIV-positive youth (15\u201324 years) in Ndola, Zambia","volume":"15","author":"JA Denison","year":"2020","journal-title":"PloS one"},{"key":"pone.0261948.ref025","volume-title":"Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention [Internet]","year":"2021"},{"issue":"1","key":"pone.0261948.ref026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"LJ Damschroder","year":"2009","journal-title":"Implementation science"},{"issue":"3","key":"pone.0261948.ref027","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1521\/aeap.2009.21.3.181","article-title":"Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis","volume":"21","author":"A Medley","year":"2009","journal-title":"AIDS Educ Prev"},{"issue":"2","key":"pone.0261948.ref028","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/her\/cyr093","article-title":"Do peer educators make a difference? An evaluation of a youth-led HIV prevention model in Zambian Schools","volume":"27","author":"JA Denison","year":"2012","journal-title":"Health education research"},{"key":"pone.0261948.ref029","author":"mothers2mothers","year":"2020","journal-title":"Mentor Mother Model: mothers2mothers"},{"issue":"2","key":"pone.0261948.ref030","doi-asserted-by":"crossref","first-page":"e264","DOI":"10.1016\/S2214-109X(19)30526-1","article-title":"Effect of a differentiated service delivery model on virological failure in adolescents with HIV in Zimbabwe (Zvandiri): a cluster-randomised controlled trial.","volume":"8","author":"W Mavhu","year":"2020","journal-title":"The Lancet Global Health"},{"key":"pone.0261948.ref031","doi-asserted-by":"crossref","first-page":"e25570","DOI":"10.1002\/jia2.25570","article-title":"Scaling up peer\u2010led community\u2010based differentiated support for adolescents living with HIV: keeping the needs of youth peer supporters in mind to sustain success","volume":"23","author":"S Bernays","year":"2020","journal-title":"Journal of the International AIDS Society"},{"issue":"3","key":"pone.0261948.ref032","doi-asserted-by":"crossref","first-page":"e0248018","DOI":"10.1371\/journal.pone.0248018","article-title":"It helps to talk: A guiding framework (TRUST) for peer support in delivering mental health care for adolescents living with HIV","volume":"16","author":"C Wogrin","year":"2021","journal-title":"PloS one"},{"key":"pone.0261948.ref033","author":"BF Crabtree","year":"1999","journal-title":"Doing qualitative research: sage"},{"issue":"4","key":"pone.0261948.ref034","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code saturation versus meaning saturation: how many interviews are enough?","volume":"27","author":"MM Hennink","year":"2017","journal-title":"Qualitative health research"},{"issue":"9449","key":"pone.0261948.ref035","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1016\/S0140-6736(04)17482-5","article-title":"Human resources for health: overcoming the crisis","volume":"364","author":"L Chen","year":"2004","journal-title":"The Lancet"},{"key":"pone.0261948.ref036","author":"World Health Organization","year":"2006","journal-title":"Working together for health: the World Health Report"},{"issue":"1","key":"pone.0261948.ref037","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1186\/1471-2458-14-1154","article-title":"\u201cIt is all about the fear of being discriminated [against]\u2026 the person suffering from HIV will not be accepted\u201d: a qualitative study exploring the reasons for loss to follow-up among HIV-positive youth in Kisumu, Kenya","volume":"14","author":"HT Wolf","year":"2014","journal-title":"BMC public health"},{"issue":"1","key":"pone.0261948.ref038","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s10900-012-9595-3","article-title":"Interpersonal relations between health care workers and young clients: barriers to accessing sexual and reproductive health care","volume":"38","author":"F Alli","year":"2013","journal-title":"Journal of community health"},{"issue":"8","key":"pone.0261948.ref039","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1089\/apc.2006.0202","article-title":"The effect of perceived stigma from a health care provider on access to care among a low-income HIV-positive population","volume":"21","author":"JJ Kinsler","year":"2007","journal-title":"AIDS patient care and STDs"},{"key":"pone.0261948.ref040","author":"The World Bank","year":"2014","journal-title":"Youth Employment in Sub-Saharan Africa"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T13:51:11Z","timestamp":1643896271000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261948"}},"subtitle":[],"editor":[{"given":"Brian C.","family":"Zanoni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,3]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261948","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,3]]}}}